Clinical trials

Hypoxia, defined as a reduction in the availability of oxygen, induces significant physiological adaptations. While the deleterious effects of severe and chronic hypoxia are well documented, several studies indicate that moderate hypoxia - particularly when administered intermittently - may produce beneficial effects on cardiometabolic health (e.g., improved regulation of blood pressure and better glycaemic control). However, its impact on the dynamics of brain circuits in humans remains relatively underexplored. The present project aims to characterise the effects of continuous and intermittent moderate hypoxia on resting-state brain dynamics in healthy adults. To this end, simultaneous electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) recordings will be conducted in order to extract functional and haemodynamic markers of brain activity. This project will contribute to a better understanding of the neurophysiological mechanisms associated with hypoxic conditioning and to the assessment of its potential application in innovative therapeutic approaches.

De novo motor learning is a specific learning paradigm that allows investigation of how a new motor skill is learned from scratch. Motor task learning can induce increased corticospinal excitability and reorganization of connectivity observed within the motor cortex (M1). Several studies have investigated the plasticity mechanisms underlying motor learning using simple paradigms. The results obtained have been variable, with a major trend toward increased corticospinal excitability, while other results show no increase. We expect to observe a significant increase in excitability and enhanced intracortical reorganization mechanisms within M1 in our subjects during our de novo motor learning sessions. The primary objective of this study is to measure changes in corticospinal excitability of the motor system across 3 de novo motor learning sessions separated by different time intervals. The secondary objectives will be: 1) to measure learning across the three practice sessions, 2) to measure changes in inhibition and facilitation across the 3 learning sessions, and 3) to measure correlations between subjects' motor performance and corticospinal and intracortical changes.

The purpose of this study is to investigate the influence of a single session of moderate aerobic exercise on motor cortex neuroplasticity in older adults, both alone and in combination with transcranial direct current stimulation (tDCS), and to compare these effects with those observed in young adults. Normal aging is associated with changes in the central nervous system that can affect motor function, sensorimotor integration, and cortical inhibitory mechanisms. These alterations may reduce the brain's capacity for neuroplasticity, which is essential for motor learning and functional adaptation. Physical exercise has been proposed as a potential strategy to counteract age-related decline in neuroplasticity. In this study, healthy young and older adults will participate in three experimental sessions. Participants will complete two experimental conditions in a randomized crossover design: (1) aerobic exercise followed by transcranial direct current stimulation (tDCS), and (2) physical inactivity followed by tDCS and a third session will assess the effects of exercise alone. Moderate aerobic exercise will consist of 20 minutes of cycling on an ergometer. Corticospinal excitability and intracortical and sensorimotor circuit function will be assessed using transcranial magnetic stimulation (TMS) before and after each intervention. Neuroplasticity will be evaluated by measuring changes in motor evoked potentials recorded from a hand muscle of the dominant side. The primary objective is to determine whether aerobic exercise enhances tDCS-induced plasticity, and whether this enhancement differs between young and older adults. Secondary objectives include evaluating age-related differences in intracortical inhibitory and facilitatory mechanisms and sensorimotor integration processes. By improving understanding of how exercise interacts with brain stimulation to modulate motor cortex plasticity, this study may help inform strategies aimed at preserving motor function and functional independence in aging populations.

Myasthenia Gravis (MG) is a rare neuromuscular disease characterized by fluctuating muscle weakness and excessive fatigability. Although medical treatments have improved, MG continues to significantly impact patients' physical, emotional, and social well-being. Current care primarily focuses on symptom management, often overlooking the broader psychosocial needs of patients. This study explores an innovative and holistic approach combining Adapted Physical Activity (APA) and Art Therapy (AT) to improve quality of life in adults with MG. The intervention includes two 6-week phases in a crossover design: one with APA alone and one combining APA with personalized AT sessions focused on body awareness, movement, and creative expression. The investigators hypothesize that the addition of AT to a standardized APA program will significantly enhance patients' engagement and well-being, resulting in improved quality of life, reduced fatigue, and better mental health outcomes. A total of 102 adult participants will be recruited from several hospitals in northern France (Lille, Dunkerque, Calais, Boulogne-sur-Mer, and Saint-Omer). Participants will be randomly assigned to begin with either APA alone or APA+AT. All interventions are tailored to the specific needs of MG patients and will be delivered both in person and online, depending on participant needs. Outcomes will be evaluated using standardized questionnaires (e.g., MG-QOL15, FSS, HADS), physical performance tests (e.g., handgrip strength, sit-to-stand), and accelerometry. Qualitative data will be collected through semi-structured interviews, ethnographic observations and art based research to better understand patients' experiences. The study has received ethical approval from the French National Ethics Committee (CPP) and involves minimal risk. Participation is voluntary, with no financial compensation. This protocol may pave the way for broader application of APA+AT models in other rare or chronic conditions that involve fluctuating fatigue and psychosocial complexity.